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Clinical Trial
. 2021 Aug;117(2):365-375.
doi: 10.36660/abc.20190844.

The Effect of Atorvastatin + Aspirin on the Endothelial Function Differs with Age in Patients with HIV: A Case-Control Study

[Article in English, Portuguese]
Gerson Gomes Dos Santos Junior  1   2 , Paulo Sérgio Ramos Araújo  1   3 , Kaliene Maria Estevão Leite  1 , Emmanuelle Tenório Godoi  4 , Adriana Ferraz Vasconcelos  4 , Heloisa Ramos Lacerda  1   4
Affiliations
Clinical Trial

The Effect of Atorvastatin + Aspirin on the Endothelial Function Differs with Age in Patients with HIV: A Case-Control Study

[Article in English, Portuguese]
Gerson Gomes Dos Santos Junior et al. Arq Bras Cardiol. 2021 Aug.

Abstract
in English, Portuguese

Background: Patients with HIV are more likely to present with cardiovascular disease when compared to the general population.

Objective: This was a case-control study that aimed to assess which factors were associated with a reduction in the carotid intima-media thickness (IMT) and an increase in the brachial artery flow-mediated dilation (FMD) in HIV patients who received atorvastatin + aspirin during a period of 6 months.

Methods: A secondary analysis of a clinical trial was conducted, which included people living with HIV infection and low cardiovascular risk. A total of 38 patients allocated to the intervention arm and treated for 6 months with a combination of atorvastatin + aspirin were included. All participants underwent a carotid and brachial artery ultrasound, both at the beginning and the end of the study. Cases that responded with an increase of >10% of the brachial dilatation (FMD) and reduction of the carotid intima-media thickness (IMT) were considered cases, and those who did not respond were considered controls. We assessed the factors associated with the positive responses obtained through IMT and FMD.

Results: A reduction in the IMT was not significantly associated with any of the evaluated risk factors: age (p=0.211), gender (p=0.260), smoking (p=0.131) or time since HIV diagnosis (p=0.836). An increase in the FMD was significantly associated with age amongst those in the 40-59 age group, p = 0.015 (OR = 4.37; 95% CI: 1.07-17.79).

Conclusions: Older individuals were more likely to present with an increased FMD after 6 months of treatment with atorvastatin + aspirin.

Fundamento: Pacientes com HIV têm maior probabilidade de apresentar doenças cardiovasculares quando comparados à população em geral.

Objetivo: Este foi um estudo de caso-controle que teve como objetivo avaliar quais fatores estavam associados a uma redução na espessura médio-intimal da carótida (IMT) da carótida e ao aumento na dilatação mediada por fluxo (DMF) da artéria braquial em pacientes com HIV que receberam atorvastatina + aspirina por um período de 6 meses.

Métodos: Foi realizada uma análise secundária de um ensaio clínico, que incluiu pessoas vivendo com HIV e baixo risco cardiovascular. Um total de 38 pacientes alocados para o braço de intervenção e tratados por 6 meses com uma combinação de atorvastatina + aspirina foram incluídos. Todos os participantes foram submetidos a ultrassonografia da carótida e da artéria braquial, tanto no início quanto no final do estudo. Os casos que responderam com aumento >10% da dilatação braquial (DMF) e redução da espessura médio-intimal da carótida (IMT) foram considerados casos, e aqueles que não responderam foram considerados controles. Avaliamos os fatores associados às respostas positivas obtidas através da IMT e DMF.

Resultados: A redução do IMT não se associou significativamente a nenhum dos fatores de risco avaliados: idade (p = 0,211), sexo (p = 0,260), tabagismo (p = 0,131) ou tempo de diagnóstico do HIV (p = 0,836). Um aumento na DMF foi significativamente associado com a idade entre aqueles na faixa etária de 40-59 anos, p = 0,015 (OR = 4,37; IC 95%: 1,07-17,79).

Conclusões: Os indivíduos mais velhos foram mais propensos a apresentar um aumento na DMF após 6 meses de tratamento com atorvastatina + aspirina.

PubMed Disclaimer

Conflict of interest statement

Potencial conflito de interesse

Não há conflito com o presente artigo

Figures

Figura 1
Figura 1. Medida da artéria braquial esquerda antes do estímulo.
Figura 2
Figura 2. Medida da artéria braquial esquerda após o estímulo.
Figure 3
Figure 3. – Medida da espessura médio-intimal da artéria carótida direita.
Figura 4
Figura 4. – Fluxograma dos participantes do estudo.
Figure 1
Figure 1. Measurement of the left brachial artery before the stimulus.
Figure 2
Figure 2. Medida da artéria braquial esquerda após o estímulo.
Figure 3
Figure 3. – Mean intimal thickness measurement of the right carotid artery.
Figure 4
Figure 4. – Flow chart of the study participants.
See this image and copyright information in PMC

Comment in

  • For which HIV Patients Aspirin and Statins are Good?
    Pezel T, Paim LR, Coelho-Filho OR. Pezel T, et al. Arq Bras Cardiol. 2021 Aug;117(2):376-377. doi: 10.36660/abc.20210560. Arq Bras Cardiol. 2021. PMID: 34495235 Free PMC article. English, Portuguese. No abstract available.

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